Cardiology mapping new approaches to treatment

ATLANTA (CNN) -- On the final day of the American Heart
Association meeting here, several recent findings reported
from a number of large, international studies may change the
way heart patients are treated.

Contrary to previous claims, for example, a study designed
specifically to test the effectiveness of vitamin E --
involving almost 10,000 patients in 19 countries, concluded
that the vitamin does not benefit the heart.

But the same study found a high-blood pressure drug called
Ramipril, also known as altace, can prevent deaths in high
risk patients.

"With Ramipril, we had a very clear reduction in the risk of
dying or having a stroke, or having a heart attack by one
quarter," said Dr. Salim Yusuf of McMaster University in
Hamilton, Ontario.

It was reported that the drug also reduced the need for
angioplasty and bypass surgery. Heart failure and the
development of diabetes were also reduced.

Another study showed that if you do have a heart attack and
are rushed to the emergency room, your odds of survival are
best if you get emergency angioplasty -- specifically,
angioplasty along with a stent -- a metal device that keeps
arteries open -- along with a blood-thinning drug.

"By implementing these types of therapies in the cardiac
cauterization laboratory with balloons, stents and these
anti-platelet drugs, we can reduce mortality to one out of
100 and save an additional five or six lives out of 100
patients treated," said Dr. Gregg Stone of Lenox Hill
Hospital.

But, according to experts, only about 20 percent of hospitals
are set up to provide this treatment.

Another research group found, to the surprise of researchers,
that aspirin alone was superior to aspirin combined with
warfarin -- a blood clotting prevention drug -- in preventing
a second heart attack.

"We hypothesized that using two agents together would have an
added benefit, but we showed that that was not the case,"
reported Dr. Michael Ezekowitz of Yale University.

Popular belief took another hit with a study that showed beta
blocker drugs did not increase survival in advanced cases.
Dr. Eric Eichhorn of the University of Texas Southwestern
said another surprise was that patients other than African-
Americans received the most benefit, suggesting that beta
blockers may not help African-Americans with heart failure.

It might appear that delegate doctors at the meeting would go
home armed with the latest treatments for their patients. But
it has been noted that it often takes years for new research
information to be translated into everyday practice.